Glomerular filtration rate is related to carotid intima-media thickness in middle-aged adults

Kastarinen, Helena; Ukkola, Olavi; Kesäniemi, Y. Antero

doi:10.1093/ndt/gfp172

Cited by 39 publications

(23 citation statements)

References 31 publications

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“…between low GFR and increased IMT. 15,16 The conflicting results may reflect shortcomings of the GFR assessments, as all these studies used GFR estimates rather than measured GFR. Two Asian studies of GFR and plaques also showed differing results.…”

Section: Discussionmentioning

confidence: 99%

Subclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population

Eriksen

Løchen

Arntzen

et al. 2014

Kidney International

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A reduced glomerular filtration rate (GFR) in chronic kidney disease is a risk factor for cardiovascular disease. However, evidence indicates that a high GFR may also be a cardiovascular risk factor. This issue remains unresolved due to a lack of longitudinal studies of manifest cardiovascular disease with precise GFR measurements. Here, we performed a cross-sectional study of the relationship between high GFR measured as iohexol clearance and subclinical cardiovascular disease in the Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6), a representative sample of the middle-aged general population. A total of 1521 persons without cardiovascular disease, chronic kidney disease, diabetes, or micro- or macroalbuminuria were examined with carotid ultrasonography and electrocardiography. The GFR in the highest quartile was associated with an increased odds ratio of having total carotid plaque area greater than the median of non-zero values (odds ratio 1.56, 95% confidence interval 1.02-2.39) or electrocardiographic signs of left ventricular hypertrophy (odds ratio 1.62, 95% confidence interval 1.10-2.38) compared to the lowest quartile. The analyses were adjusted for cardiovascular risk factors, urinary albumin excretion, and fasting serum glucose. Thus, high GFR is associated with carotid atherosclerosis and left ventricular hypertrophy and should be investigated as a possible risk factor for manifest cardiovascular disease in longitudinal studies.

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Section: Discussionmentioning

confidence: 99%

Subclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population

Eriksen

Løchen

Arntzen

et al. 2014

Kidney International

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“…One in five diabetic patients progresses to end-stage renal disease within 20 years of nephropathy onset [6]. Cardiovascular complications start early in renal disease with even minor renal deterioration being associated with arterial thickening [7]. Current therapies may not arrest renal function decline and there is an urgent need for new targets and interventions [8], as renal failure and associated cardiovascular disease increase mortality rates [9].…”

Section: Introductionmentioning

confidence: 99%

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

et al. 2010

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Aims/hypothesis Fenofibrate caused an acute, sustained plasma creatinine increase in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) studies. We assessed fenofibrate's renal effects overall and in a FIELD washout sub-study. Methods Type 2 diabetic patients (n=9,795) aged 50 to 75 years were randomly assigned to fenofibrate (n=4,895) or placebo (n=4,900) for 5 years, after 6 weeks fenofibrate run-in. Albuminuria (urinary albumin/creatinine ratio measured at baseline, year 2 and close-out) and estimated GFR, measured four to six monthly according to the Modification of Diet in Renal Disease Study, were pre-specified endpoints. Plasma creatinine was re-measured 8 weeks after treatment cessation at close-out (washout sub-study, n=661). Analysis was by intention-to-treat. Results During fenofibrate run-in, plasma creatinine increased by 10.0 μmol/l (p<0.001), but quickly reversed on placebo assignment. It remained higher on fenofibrate than on placebo, but the chronic rise was slower (1.62 vs 1.89 μmol/l annually, p=0.01), with less estimated GFR loss (1.19 vs 2.03 ml min −1 1.73 m −2 annually, p<0.001). After washout, estimated GFR had fallen less from baseline on fenofibrate (1.9 ml min −1 1.73 m −2 , p=0.065) than on placebo (6.9 ml min −1 1.73 m −2 , p<0.001), sparing 5.0 ml min

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“…Sharing of established cardiovascular risk factors – such as age, gender, blood pressure, cholesterol, smoking and diabetes – can explain some, but not all excess stroke risk in patients with CKD 3 . Sharing of pathophysiological correlates of vascular disease including carotid atherosclerosis 7 , arterial stiffness 8 , and cerebral white matter hyperintensity (WMH) lesions 9 also appear to explain an additional component, but not all of the excess risk.…”

Section: Introductionmentioning

confidence: 99%

Polygenic Overlap Between Kidney Function and Large Artery Atherosclerotic Stroke

Holliday¹,

Traylor

Malik

et al. 2014

Stroke

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Background and Purpose Epidemiological studies show strong associations between kidney dysfunction and risk of ischaemic stroke, the mechanisms of which are incompletely understood. We investigated whether these associations may reflect shared heritability due to a common polygenic basis and whether this differed for ischaemic stroke subtypes. Methods Polygenic models were derived using GWAS meta-analysis results for three kidney traits: estimated glomerular filtration rate using serum creatinine (eGFRcrea: N=73,998), eGFR using cystatin C (eGFRcys: N=22,937) and urinary albumin to creatinine ratio (UACR: N=31,580). For each, SNPs passing ten P-value thresholds were used to form profile scores in 4,561 ischaemic stroke cases and 7,094 controls from the UK, Germany and Australia. Scores were tested for association with ischaemic stroke and its three aetiological subtypes: large artery atherosclerosis (LAA), cardioembolism (CE) and small vessel disease (SVD). Results Polygenic scores correlating with higher eGFRcrea were associated with reduced risk of LAA, with five scores reaching P<0.05 (peak P=0.004) and all showing the epidemiologically expected direction of effect. A similar pattern was observed for polygenic scores reflecting higher UACR, of which three associated with LAA (peak P=0.01) and all showed the expected directional association. One UACR-based score also associated with SVD (P=0.03). The global pattern of results was unlikely to have occurred by chance (P=0.02). Conclusions This study suggests possible polygenic correlation between renal dysfunction and ischaemic stroke. The shared genetic components may be specific to stroke subtypes, particularly large artery atherosclerotic stroke. Further study of the genetic relationships between these disorders appears merited.

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Glomerular filtration rate is related to carotid intima-media thickness in middle-aged adults

Cited by 39 publications

References 31 publications

Subclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population

Subclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

Polygenic Overlap Between Kidney Function and Large Artery Atherosclerotic Stroke

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